Provider Demographics
NPI:1467493387
Name:PASADENA LABORATORY SERVICES, INC
Entity Type:Organization
Organization Name:PASADENA LABORATORY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-792-8862
Mailing Address - Street 1:1250 E WALNUT ST
Mailing Address - Street 2:SUITE 136
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1893
Mailing Address - Country:US
Mailing Address - Phone:626-792-8862
Mailing Address - Fax:
Practice Address - Street 1:1250 E WALNUT ST
Practice Address - Street 2:SUITE 136
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1893
Practice Address - Country:US
Practice Address - Phone:626-792-8862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF11760291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory